Saturday, 2 May 2009

New York cannot test all Swine Flu

New York Tests

New York health officials will test for swine flu only in patientswith a severe illness or if there's a cluster of cases, HealthCommissioner Thomas Frieden said at a news conference yesterday. Allof New York's 49 confirmed cases and the more than 1,000 suspectedhave had symptoms similar to those of seasonal flu, he said.

This is bad news. It shows that as the number of cases increase, itbecome difficult to confirm whether it is Swine Flu(H1N1 A) or otherflus.

May 2 (Bloomberg) -- Swine flu reached 15 countries and there'sevidence the new virus is spreading in five nations among peopleunconnected to Mexico. The symptoms may be no more severe thanseasonal flu, health officials said.

In little more than a week, world health authorities have tracked theemergence of swine flu, formally known as H1N1, from a few cases inTexas and California to the brink of the first influenza pandemicsince 1968. Thousands of cases were suspected. At least 433 U.S.schools closed yesterday, a hotel was quarantined in Hong Kong andContinental Airlines Inc. cut seating capacity on flights to Mexico inhalf.

The U.K., U.S., Germany, Canada and Spain each confirmed cases inpeople who didn't travel to Mexico, where the virus has struckhardest. The expanding wave of sickness has been similar to seasonalflu, though health authorities are taking no chances with a virus thatmay flash across the globe, infecting a population with no naturalimmunity, said the U.S. Centers for Disease Control and Prevention.

"Even though we might be seeing only mild cases now, we cannot saywhat will happen in the future," Gregory Hartl, a spokesman for theWorld Health Organization, told reporters yesterday. "If at the end ofthe day it remains a mild pandemic or if we can somehow avert theworst of the disease or stop the worst of the disease, then that'sfantastic. We will have done our job well."

Ten Deaths

South Korea confirmed its first case today, in a 51-year- old nun whoreturned home April 26 after a week-long period of aid activities inMorelos, Mexico, health authorities in the North-Asian nation said.They're treating a 44-year-old colleague as a "probable" infection andthe nation's first case of human-to-human transmission.

A Tokyo laboratory is testing to determine if a baby at a U.S.military base in Japan is infected.

Hong Kong, France and Denmark confirmed their first cases yesterday.Hong Kong declared a public-health emergency after detecting the virusin a 25-year-old traveler from Mexico, and cordoned off the hotel inwhich he was staying, confining guests and staff.

The Geneva-based WHO raised its six-tier pandemic alert to 5 on April29 and may move soon to the highest level. Stage 6 would signal apandemic and alert governments to enact plans against the disease.

The virus is already at pandemic level, according to Ira Longini, aresearcher at the University of Washington in Seattle who advises theU.S. government on flu.

Pandemic Level

"The definition of a pandemic is that the new virus has spread toseveral countries and is transmissible," Longini said in an interviewyesterday. "It's hard to imagine it's not going to continue to spreadin some form."

Laboratory tests verified that at least 615 people in North America,Europe, Asia and New Zealand had the illness, with 10 deaths,according to WHO's Web site. New York officials said they suspect morethan 1,000 cases, so many that the government has stopped testing allbut the sickest there.

"We need to prepare for the long-term," President Barack Obama saidyesterday in Washington. "Even if it turns out that the H1N1 isrelatively mild on the front end, it could come back in a morevirulent form during the actual flu season."

Evidence suggests "transmission is widespread, and that less severeillness is common," the Atlanta-based CDC said in a report yesterday.In Mexico, where WHO said nine of the world's 10 confirmed deaths fromthe virus occurred, "a large number of undetected cases of illnessmight exist in persons seeking care in primary-care settings or notseeking care at all," the CDC report said.

New York Tests

New York health officials will test for swine flu only in patientswith a severe illness or if there's a cluster of cases, HealthCommissioner Thomas Frieden said at a news conference yesterday. Allof New York's 49 confirmed cases and the more than 1,000 suspectedhave had symptoms similar to those of seasonal flu, he said.

In the U.S., at least 433 schools closed yesterday in 17 states,leaving parents to find other arrangements for 245,449 students,according to the Education Department. Five colleges closed, thedepartment said in an e-mail.

The CDC raised its flu count to 141 cases in 19 states, including theonly U.S. fatality, a 22-month-old child who died April 27 at aHouston hospital.

Pigs, People, Birds

The new influenza strain, a conglomeration of genes from swine, birdand human viruses, poses the biggest threat of a flu pandemic since2003, when the H5N1 strain killed millions of birds and hundreds ofpeople, William Schaffner, an influenza expert at VanderbiltUniversity School of Medicine in Nashville, Tennessee, said in aninterview yesterday.

"In Nashville, we are getting the sense that out in our communitythere is a lot of relatively mild influenza illness among children andincreasing among their parents -- much of this is suspected to beH1N1," Schaffner said. "By now our usual influenza season is over byweeks, but that's clearly not the case."

The 2003 avian flu killed more than half of the people who got it. Itdidn't spread from person to person and only infected 421 people. TheSpanish flu of 1918, another version of bird flu, killed as many as 50million people in one of history's deadliest outbreaks.

Evolving Viruses

"There are some genetic tests that have shown the virus we're dealingwith right now does not have the factors that we think made the 1918virus so bad," said Julie Gerberding, former head of the CDC, in aninterview yesterday on ABC News. "But we have to be careful not toover-rely on that information, because these flu viruses alwaysevolve."

Batches of seed virus are being developed for potential vaccineproduction, according to WHO. Paris-based Sanofi-Aventis SA, BaxterInternational Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc ofLondon are talking with world health authorities about producingshots, the agency said.

"It seems most likely that the manufacturers will proceed and we willcertainly support them," Marie-Paule Kieny, WHO's vaccine director,told reporters in Geneva.

Production of vaccines against the new H1N1 influenza will becompleted "in parallel with or after the seasonal vaccine isproduced," Nancy Cox, chief of the flu division at the CDC's Centerfor Immunization and Respiratory Disease, at a news conference todayin Atlanta.

Jose Cordova, the health minister in Mexico, said yesterday the numberof H1N1 flu cases confirmed by laboratory tests climbed to 381 and thedeath toll rose to 16. Deaths will probably continue, he said.

WHO's statistics, which lag behind those reported by national andlocal agencies, confirmed cases in the U.S., Mexico, Canada, the U.K.,Austria, Germany, the Netherlands, Denmark, Switzerland, Spain,Israel, Hong Kong and New Zealand. France and South Korea have alsoconfirmed cases.

The three main seasonal flu strains -- H3N2, H1N1 and type- B -- cause250,000 to 500,000 deaths a year globally, according to WHO. The newflu's symptoms are similar, including fever and coughing, nausea andvomiting, according to the CDC.

Authorities advised hand-washing, hygiene and staying home if sick asthe most effective ways to control the outbreak.

To contact the reporters on this story: Tom Randall in New York attrandall6@bloomberg.net.Last Updated: May 2, 2009 02:29 EDT